Summary & Overview
CPT 83655: Lead Quantification Laboratory Test
CPT code 83655 identifies a laboratory assay that quantifies lead levels in patient specimens to detect and monitor lead exposure. This test is an important public health and clinical tool for diagnosing lead poisoning, guiding treatment decisions, and supporting occupational and environmental health surveillance. Nationally, lead testing remains relevant due to ongoing concerns about environmental exposure, vulnerable populations such as children and pregnant people, and workplace monitoring requirements.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of CPT code 83655, clinical context for when the test is used, and what settings typically perform the service. The publication provides benchmarks and coverage considerations, coding and billing essentials, and notes on clinical indications and utilization patterns. It also summarizes common modifiers associated with lab services and highlights areas where policy updates or payer-specific requirements may affect coverage or claims processing. Data not available in the input is explicitly noted where relevant.
Billing Code Overview
CPT code 83655 describes a laboratory assay that measures the amount of lead in a patient specimen. The test is used to assess lead exposure and quantify blood or specimen lead concentration for clinical evaluation, public health screening, occupational monitoring, or case management.
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Service type: Clinical laboratory test (lead quantification)
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Typical site of service: Clinical laboratory or hospital laboratory; specimens are collected in ambulatory clinics, occupational health clinics, or inpatient settings and analyzed in a laboratory testing facility.
Clinical & Coding Specifications
Clinical Context
A 3-year-old child is brought to a pediatric clinic by a daycare provider after routine screening identified potential elevated blood lead levels. The clinician obtains a blood sample for a quantitative lead level test to assess environmental exposure from old housing or occupational take-home exposure. The specimen is sent to the clinical laboratory where a medical technologist or lab analyst performs 83655 (blood lead level) using atomic absorption spectrometry or inductively coupled plasma mass spectrometry. Results are reported to the ordering provider and public health authorities as required. Follow-up may include repeat testing, environmental investigation, and coordination with pediatric toxicology or public health services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
91 | Repeat clinical diagnostic laboratory test | Use when the same specimen is re-tested to confirm results without a new collection |
90 | Qualifying circumstances for laboratory tests (state/other) | Use when testing is performed for public health reporting or mandated screening outside usual circumstances |